If this application has been submitted without a fee, indicate reason for fee exemption (see 47 C.F.R. Section 1.1114):Governmental Entity
Fee-exempt Report
Other
Other
N/A (Fee Required)

5.

All of the information furnished in this Report is accurate as of
(Date entered must (1) be Oct. 1 of the filing year when filing a Biennial Ownership Report (or Nov. 1, 2009 in the case of the initial filing); or (2) be no more than 60 days prior to the date of filing when filing a non-biennial Ownership Report.)

6.

Purpose: This Report is filed for: (choose one)

a.
Biennial

b.
Validation and Resubmission of a previously filed Biennial Report (certifying no change from previous Report)

c.
Transfer of Control or Assignment of License/Permit

d.
Report by Permittee filing within 30 days after the grant of a construction permit for a new commercial AM, FM or full power television broadcast station.

e.
Update / certification of accuracy of an initial Ownership Report filed by Permittee (filing in conjunction with Permittee's application for a station license)

f.
Amendment to a previously filed Ownership Report

File Number: -

If an Amendment, submit as an Exhibit a listing by Section and Question Number the portions of the previous Report that are being revised.

7.

Licensee and Station Information. The stations listed below are all licensed to the following person or entity:

Contract Information. List all contracts and other instruments required to be filed by 47 C.F.R. Section 73.3613. (Only Licensees, Permittees, or Respondents with a majority interest in or that otherwise exercise de facto control over the subject Licensee or Permittee shall respond. Other Respondents should select "Not Applicable" in response to this question.) If the agreement is a local marketing agreement (LMA) or a joint sales agreement (JSA), or if the agreement is a network affiliation agreement, check the appropriate box; otherwise, select "Other" for non-LMA/JSA or network affiliation agreements.
Not
Applicable

Contract Information

2.

Capitalization (Only Licensees
, Permittees,
or entities with a majority interest in or that otherwise exercises de facto control
over the subject Licensee shall respond.)
Not Applicable

Capitalization Information

(Check/
Uncheck All)

3.

(a.)

Ownership Interests. This Question requires Respondents to enter detailed information about ownership interests by generating a series of subforms. Answer each question on each subform. The first subform listing should be for the Respondent itself. If the Respondent is not a natural person, also list each of the officers, directors, stockholders, noninsulated partners, members and other persons or entities with a direct attributable interest in the Respondent. (A "direct" interest is one that is not held through any intervening companies or entities.) In the case of vertical or indirect ownership structures, report only those interests in the Respondent that also represent an attributable interest in the Licensee or Permittee for which the Report is being submitted.

List each person or entity with a direct attributable interest in the Respondent separately. Entities that are part of an organizational structure that includes holding companies or other forms of indirect ownership must file separate ownership reports. In such a structure do not report or file separate reports for persons or entities that do not have an attributable interest in the Licensee or Permittee for which the report is being submitted.

Ownership Interests Information

(Check/
Uncheck All)

(b.)

Respondent certifies that any equity and financial interests not reported in response to Question 3(a) are non-attributable.

If "No," submit as an Exhibit an explanation.

Yes
No

(c.)

Does the Respondent or any person/entity with an attributable interest in the Respondent also hold an
attributable interest in any other broadcast station, or in any newspaper entities in the same market, as
defined in 47 C.F.R. Section 73.3555?

If "Yes", provide information describing the interest(s), using EITHER the subform OR the spreadsheet option below for the applicable type of interest (broadcast or newspaper). Respondents with a large number (50 or more) of entries to submit should use the spreadsheet option. NOTE: Spreadsheets must be submitted in a special "XML Spreadsheet" format with the appropriate structure that is specified in the documentation. For instructions on how to use the spreadsheet option to complete this question (including templates to start with), please Click Here.

Broadcast Interest Information

Newspaper Interest Information

Yes
No

(d.)

Are any of the individuals listed in response to Question 3(a) married, related as parent-child, or related as
siblings?

If "Yes", complete the information describing the relationship.

Familial Relationships

(Check/Uncheck All)

Yes
No

(e.)

Is Respondent seeking an attribution exemption for any officer or director with duties unrelated to the
Licensee
or Permittee
?

If "Yes", complete the information in the required fields and submit an Exhibit fully describing that
individual's duties and responsibilities, and explaining why that individual should not be attributed an
interest.

Exemption Information List

(Check/Uncheck All)

Yes
No

SECTION III - CERTIFICATION

I certify that I am

(Official Title)

of

(Exact legal title or name of Respondent)

and that I have examined this Report and that to the best of my knowledge and belief, all statements in this Report are true, correct and complete.

(Date of the signature below must (1) be no earlier than Oct. 1 of the filing year when filing a Biennial Ownership Report (and no earlier than Nov. 1, 2009 in the case of the initial filing); or (2) be no more than 60 days prior to the date of filing when filing a non-biennial Ownership Report.)